Esophageal Cancer

Esophageal Cancer

The Esophagus

What is cancer of the esophagus?

The esophagus is a muscular tube that connects the mouth to the stomach. It carries food and liquids to the stomach. The esophagus is about 10-13 inches long.

Esophageal cancer is a disease in which cancerous cells form in the tissues of the esophagus.

Esophageal Cancer Staging

The initial clinical stage of the patient depends on integration of information obtained through biopsy, imaging and surgical staging.

Therapy depends on accurate diagnosis from endoscopic biopsy and staging, which is often done with chest Computerized Tomography (CT), PET CT Endoscopic Ultrasound (EUS), or, when indicated, endoscopic mucosal resection (or EMR). It also depends on the overall functional status of the patient.

All biopsies and scans obtained at outside institutions are reviewed at Fox Chase.

VATS for Esophagectomies
Minimally Invasive Esophagectomies

Fox Chase is a regional center of excellence in esophageal surgery with high patient volumes.

The largest number of minimally invasive esophagectomies in the Philadelphia area for patients with esophageal cancer have been performed here at Fox Chase.

With conventional, open surgery, an esophagectomy required a laparotomy (accessing the abdominal cavity through an incision in the abdominal wall) and thoracotomy (a large incision between the ribs).

Today, using minimally invasive techniques, such as video assisted thoracic surgery (VATS), surgeons can perform esophagectomies with fewer complications, improved quality of life and better outcomes, and without compromising oncologic principles.

Treatment Team

The Esophageal Cancer Team includes, among others you might see:

Gastroenterologists
Gregory H. Enders, MD, PhD
Stephen J. Heller, MD
Jeffrey L. Tokar, MD

Medical Oncologists
Igor Astsaturov MD, PhD
Steven J. Cohen, MD
Crystal S. Denlinger, MD
Efrat Dotan, MD
Paul F. Engstrom, MD
David S. Weinberg, MD, MSc

Pathology
Harry S. Cooper, MD

Radiation Oncologist
Joshua Meyer, MD

Surgical Oncologists
Walter J. Scott, MD, FACS
Prashant C. Shah, MD
Elin Sigurdson, MD, PhD, FACS
Donna Edmondson, MSN, CRNP, OCN

Nurse Navigators
Norma Fenerty, BSN, RN-BC, OCN
Catherine MacFarland, RN, BSN, OCN
Debbie Seremelis-Scanlon RN, BSN, OCN, CHPN

Esophageal Cancer Treatment

Early Stages
Surgery is the best treatment option for early stages of the esophageal cancer. Fox Chase surgeons, such as Walter J. Scott, MD, FACS offer an individualized tailored surgical approach that integrates the patient functional status and stage. Most patients with esophageal cancer present with locally advanced disease.

At Fox Chase, these patients are usually offered a multidisciplinary multimodality treatment approach starting with confirmation of staging with laparoscopy. During this procedure the surgeon evaluates the location and extent of the esophageal cancer and excludes microscopic carcinomatosis. Additionally, a feeding tube is placed in the small bowel and a 'port' device is placed into a central vein to facilitate future chemotherapy. The patient then receives combined chemo and radiation therapy. Upon completion of chemoradiation, restaging scans are obtained and surgery is offered to the majority of the patients. We feel that nutritional support during neoadjuvant chemoradiation enables the patient to complete intended therapy and reach surgery stronger.

We tailor our surgical procedure to the patient; however we are able to offer Minimally Invasive Esophagectomy to most even after prior chemoradiation.

Metastatic
Chemotherapy is the mainstay of treatment for metastatic esophageal cancer. Clinical trials have shown that chemotherapy increases survival rates among patients.

Treatment Options

Doctors at Fox Chase Cancer Center offer a variety of treatment options for patients with esophageal cancer, including:

  • Surgery is the most common treatment for esophageal cancer. In the procedure, an esophagectomy, the surgeon removes part of the esophagus.
  • Radiation therapy. Both internal and external radiation are used to treat the tumor.
  • Chemotherapy. Anti-cancer drugs are directed into the spinal column, on organ or body cavity to treat the cancer cells that area.
  • Endoscopic Mucosal Resection is the use of an endoscope in order to remove premalignant and non-invasive cancer

Clinical Trials

Currently, patients with esophageal cancer have the opportunity to participate in a clinical trial that involves a combination of chemotherapy and radiation therapy with new drugs prior to surgery to improve cure rates. Clinical trials for esophageal cancer, including Phase I trials, are available at Fox Chase Cancer Center.

Special Needs

Patients with esophageal cancer have special nutritional needs. It is difficult to swallow, so many patients find it hard to eat. The esophagus may be narrowed by the tumor or as a side effect of treatment. Nutrition may be given intravenously or through a feeding tube.
Read more on Nutrition Services »

[6/23/2014]

April is Esophageal Cancer Awareness Month

The Esophageal Cancer treatment and support staff at Fox Chase Cancer Center

The Esophageal Cancer treatment and support staff at Fox Chase Cancer Center, marking Esophageal Cancer Awareness Month, April 2013

Request an Appointment
Find a Clinical Trial

Blue Distinction

Blue Cross/Blue Shield

Fox Chase is a Blue Distinction Center for Esophageal Cancer Treatment
Read more »

Symptoms of esophageal cancer
Listen Now

Esophageal cancer can be difficult to diagnose.

Robert Kabaci
Read more Patient Stories

Bobby Kabaci suffered from heartburn since he was a child. Growing up, he became so used to it that it never really occurred to Bobby to go to his doctor.

Read Esophageal Cancer
Patient Stories »

See National Cancer Institute information on Esophageal Cancer

Minimally Invasive Esophagectomy: A Better Surgical Option for Patients with Esophageal Cancer

by Walter J. Scott, MD, FACS
April 26, 2013

Read more at
Cancer Conversations
»

Esophagectomy Support Group

Men and women diagnosed with esophageal cancer who are considering surgery or who have had surgery are invited to attend a monthly support group sponsored by Fox Chase Cancer Center.
Information and registration

Resources and Education for Patients and their families

The Resource and Education Center

Cancer Questions?
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